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SEAFOOD ALLERGIES ( 1999 )

Perhaps you’ve read reports that eating fish can deliver health benefits. Besides offering a lean source of protein, some fish contain fatty acids that may help to prevent coronary artery disease.The positive publicity has boosted the demand for seafood. But some people have to weigh the health benefits of seafood against the costs — including a possible trip to the emergency room. These are people with allergies to fish and shellfish.

Fish and heart health - Make fish a regular on your plate
A common food allergy

Seafood is a common source of food allergies. About 250,000 Americans experience allergic reactions to fish and shellfish.

People with seafood allergies can have symptoms that range from mild to life-threatening. Even tiny amounts of fish substances can trigger a reaction in some people.

What’s more, these allergies are rarely outgrown. People with childhood allergies to other foods often find that their symptoms disappear in adulthood. But allergies to seafood typically last a lifetime.

Know the culprits

The general category of “seafood” includes a long list of shellfish. Some examples are:

Shrimp

Crab

Crayfish

Lobster

Oyster

Clam

Scallop

Mussels

Squid

Snail

Fish such as cod, salmon, trout, herring, sardine, bass, orange roughy, swordfish and tuna can cause allergic reactions.

Spot the symptoms

People with allergies to fish and shellfish can experience any of the classic food allergy symptoms. These include:

Nasal congestion

Hives

Itching

Swelling

Wheezing or shortness of breath

Nausea

Upset stomach, cramps, heartburn, gas or diarrhea

Lightheadedness or fainting

Food poisoning symptoms can mimic those of food allergies, but they are distinct problems. “Fish and shellfish spoil easily,” says James T. Li, M.D., a specialist in allergies, asthma and immunology at Mayo Clinic, Rochester, Minn. “In some cases, spoiled fish can contain histamine, a substance that causes hives and flushing. If someone eats the spoiled fish, they can have symptoms similar to an allergic reaction. But this is actually a type of food poisoning.”

Call for an evaluation

If you suspect that you have any food allergies, see an allergist for a careful evaluation. This generally includes a medical history, physical exam, and skin or blood testing.

“A careful evaluation will help us accomplish two goals,” says Dr. Li. “One is to determine with certainty whether or not you have an allergy to fish or shellfish. Second, testing helps us identify which types of seafood could trigger your allergies. Then we can give you useful advice about what you can and can’t eat safely.”

Prevent allergic reactions

Above all, prevention means avoidance. “Steering clear of the fish and shellfish that you’re allergic to is the best advice we can give anybody,” says Dr. Li.

While this advice can be challenging enough to follow at home, it calls for even more caution at restaurants. Keep three points in mind:

Avoid seafood dishes that could trigger an allergic reaction.

Look out for other dishes that might contain seafood as an ingredient.

If you’re highly allergic to fish or shellfish, take extra care. You could have a reaction even if you eat a “safe” dish that was cooked in pans used to prepare seafood.

In addition, you can:

Avoid allergy myths. For example, there’s a myth that allergy to fish represents an allergy to iodine. This leads some people to avoid the iodine used in skin medications or medical tests. Actually, there’s no connection between allergies to fish or shellfish and allergies to iodine.

Read food labels. Avoid highly processed foods. They might include fish or shellfish as an ingredient.

Let other people know about your allergies. If you have severe food allergies, wear a medical alert bracelet or necklace. These list your symptoms and explain how others can help you in a medical emergency.

Be prepared to treat yourself. If your doctor advises it, learn how to give yourself a shot of adrenaline to treat an allergic reaction. You can carry a small, convenient kit for this purpose.

Food allergies - Widely misunderstood
Go for a personal plan

“The main thing to remember about food allergy management is that medical advice must be individualized,” Dr. Li says. “We do not have a standard set of recommendations to give everybody with these kind of allergies, including allergies to fish and shellfish. What you as an individual need to do depends on how serious your reaction is and how much you like to eat fish.”

The ideal approach to food allergies takes these personal factors into account. Some people might find they need to avoid all fish and shellfish. Others might be able to eat certain seafoods while avoiding others.

With careful allergy testing and treatment planning, you can reach a balance that allows you to enjoy food — and keep your allergies in check.